Provider Demographics
NPI:1104048636
Name:COMMUNITY COUNCIL OF SOUTHWEST TEXAS, INC.
Entity type:Organization
Organization Name:COMMUNITY COUNCIL OF SOUTHWEST TEXAS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ELSA
Authorized Official - Middle Name:A
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:830-278-6268
Mailing Address - Street 1:P. O. DRAWER 1709
Mailing Address - Street 2:
Mailing Address - City:UVALDE
Mailing Address - State:TX
Mailing Address - Zip Code:78802-1709
Mailing Address - Country:US
Mailing Address - Phone:830-278-6268
Mailing Address - Fax:830-278-4281
Practice Address - Street 1:420 W. NOPAL
Practice Address - Street 2:
Practice Address - City:UVALDE
Practice Address - State:TX
Practice Address - Zip Code:78801
Practice Address - Country:US
Practice Address - Phone:830-278-8868
Practice Address - Fax:830-279-0253
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service